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Review Question - QID 3552

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QID 3552 (Type "3552" in App Search)
A patient develops infrapatellar contracture syndrome after undergoing ACL surgery. All of the following findings are consistent with this diagnosis EXCEPT?

Patella infera

2%

63/3456

Decreased patellar mobility

1%

51/3456

Loss of active but not passive flexion

66%

2275/3456

Loss of full extension

16%

556/3456

Loss of passive flexion

14%

497/3456

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All of the listed responses are consistent with infrapatellar contracture syndrome EXCEPT for Answer #3 which is incorrect because the resulting stiffness affects both active and passive motion.

This is an uncommon complication following knee surgery or injury which results in knee stiffness. The resulting stiffness limits both active and passive range of motion (ROM) and usually results in loss of flexion, extension, and patellar mobility. The development of patella infera (baja) on lateral radiographs is a common sequela and also a poor prognostic sign.

Paulos et al. describe the risk factors and their results of treatment. ACL surgery is a risk factor, as is the use of a patellar tendon autograft, multiple knee surgeries, and non-isometric tunnel placement. In patients with this condition, the use of closed manipulation and the development of patella infera are negative prognostic factors. Surgical releases are recommended to improve motion, but residual functional impairment and only fair subjective scores should be expected.

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